Mutya C. Profile

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$5 USD / hour

pasig city,

philippines

$5 USD / hour

It's currently 7:47 AM here

Joined July 19, 2017

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Mutya C.

@mutyacarilo

0.0

(0 reviews)

0.0

$5 USD / hour

pasig city,

philippines

$5 USD / hour

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Jobs Completed

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On Time

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Repeat Hire Rate

Freelance Virtual Assistant

Extensive experience in Health Insurance benefits and claims processes, MS Office applications, high-level attention to details, proven problem-solving skills and ability to work across cultures with a geographically dispersed user community and support groups. My approach of 'Doing it right the first time' and passion for delivering quality results has helped me excel in all of the work experiences that I have undertaken over the years.I'm dedicated to fulfilling your work requirements. Talk to me for 30 seconds and see the difference. Looking forward to working with you!

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Portfolio

• Analyzed and processed health insurance claims from customers in US while exceeding the financial, processing and payment standards of the client.
• Assigned as Cluster team Lead and accomplished time status reports.
• Checked and filter out fraudulent claims and analyze error trends.
• Attend company and client sponsored trainings on processing optimization.
• Consistent monthly top performer in Claims processing and obtained the 2nd highest grade during the project pre-training.

Insurance Claims Analyst

• Top performer in Accuracy and Productivity for Canadian Group Benefits-Claims 2007-2009.
• Recognized as the subject matter expert in health insurance adjudication, processed the payment of health insurance claims of clients, hospitals and pharmacies.
• Evaluated and processed scanned claims for drugs, hospital, and paramedical benefits into the client’s database.
• Resolved customers’ concerns and issues minimizing complaints from clients’ end.
• Identified, investigated and reported fraudulent claims and error trends by doing reports submitted to the Management.
• Assigned to do inventories of stagnant old claims, created weekly reports about claim status, and ensured all scanned documents are kept up-to-date and in-synch with other documentations and always reached the allotted quota in adjudication.
• Performed regular production monitoring and reporting tasks.
• Undergone trainings on different processing techniques and optimization of the system.
• Monitored Canadian health law

Health Insurance Claim Adjudicator (Canadian Account)

• Monthly Top performer achievements in Accuracy, Productivity and Quality standard set by the company and clients for more than a year.
• Handled daily sending of enrollment and eligibility emails using the given standard set by the US clients.
• Delivered beyond the stated task objectives and proactive in dealing with clients and issues.
• Provides timely updates and procedures on relevant information, also conduct on-call trainings and remote staffing with the clients.
• Addressed client requests, respond to tickets immediately and proposes solutions to minimize delays and setbacks in completing work.
• Created data discrepancy reports, daily and weekly task audit reports and emails it to the clients. Also, ensured all emails sent,
documentations and procedures are up to date.
• Able to complete multiple projects with tight deadlines, while undergoing different training communication skills enhancements

Benefits Administration Specialist

Insurance Claims Analyst

Health Insurance Claim Adjudicator (Canadian Account)

Benefits Administration Specialist

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Experience

Accenture, Manulife Business Processing Services., Proview Global Administration, Inc.

May 2006 - Jun 2012 (6 years, 1 month)

Handled medical/benefits claims, sent emails correspondence, did Quality Audits, responsible for Discrepancy Reports of fraudulent claims and delivered beyond the stated task objectives and proactive in dealing with clients and issues.Also, provided timely updates and procedures on relevant information, conducted on-call seminars and remote staffing with the clients. Achieved as one of the top monthly performer in Quality, Accuracy and Productivity set by the company and clients.

Education

AB Sociology

Bicol University,

Philippines

2000 - 2006

(6 years)

Qualifications

Proview Global Inc.

2011

HIPAA stands for the Health Insurance Portability and Accountability Act and is a U.S. federal law enacted in 1996 as an attempt at incremental healthcare reform. HIPAA's intent was to reform the healthcare industry by reducing costs, simplifying administrative processes and burdens, and improving the privacy and security of patients' health information. Today HIPAA compliance mainly revolves around the last item: protecting the privacy and security of patients' health information.